Intravenous Erythromycin

Residual blood and clot in the stomach limits visibility and hinders therapeutic intervention. Erythromycin is a motilin agonist that induces gastric emptying. Frossard and colleagues (2002) suggested that infusion of erythromycin before endoscopy in patients with recent hematemesis makes endoscopy shorter and easier and reduces the need for a repeat procedure. Patients admitted within 12 hours of hematemesis (n = 105) were randomly assigned to intravenous (IV) erythromycin (250 mg) or placebo administered 20 minutes before endoscopy. A clear stomach was found more often in the erythromycin group (82% vs. 33%; p < .001). Erythromycin shortened the procedure (13.7 vs 16.4 minutes; p = .036) and reduced the need for second-look endoscopy (6 vs 17 cases; p =.018). The length of stay and the transfusion requirement did not differ significantly between the 2 groups and no complications were noted.

Another study randomized 41 patients to either ery-thromycin (3 mg/kg IV over 30 minutes) or no treatment (Coffin et al, 2002). Endoscopy was performed 30 to 90 minutes after the infusion (unblinded) and the quality of the examination was assessed on a subjective scale. The need to perform a second diagnostic endoscopy was also assessed. The qualities of the endoscopic examinations were significantly better in the erythromycin group (score 2.5 vs 1.5; p = .02), but the difference in the number of patients who required a second diagnostic endoscopy was not statistically significant (3 vs 10; p = .089), although there was a trend in that direction. Erythromycin did not interfere with the endoscopy and no adverse events were observed.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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